Back Pain - I have a contract with my pain mgmt doctor in CA, but he refuses to give me enough pain?

Responses (5)

I am in the same boat. You will have to do a ton of research to find a new Dr. Then get a new contract with him. He will contact your other Dr ( when you tell him who he was) & most likely ask for records of the last 3 visits then if you chise to stay with the new one cancel the contract you had with your old one. I also learned from 10 years of suffering & getting pain meds that pain management Drs are the worst ones to go to. If you can, try to find a primary care or neurologist Dr that will provide you with the meds, some of them can & will prescribe pain meds. I have been to 14 pain management places for just a consultation, only 2 of them would even prescribe narchotics. You can go & visit new Drs you just can't get meds from them unless you sign a new contract & he will cancel the other one. I am so disgusted & tired of running around I am ready to crack up.Good Luck.

Wow, I havent had near the touble Oceanman has had. I have found the opposite here in AZ. Pain management are the only ones who prescribe. General practice or family practice Drs here dont like to prescribe much at all-to get big guns you have to go to pain managemnt. Strange isnt it how it is so different from area to area? If your Dr wont prescribe any more medication you can try another Dr. Like Oceanman said, you can go for consult and if you decide that you like the new Dr better you need to cancel your contract with your old doc before the new one prescribes so you dont get into trouble for Dr shopping. With this new REMS policies coming through, there are a lot of changes coming down the pipes and now Drs who didnt used to do UDS are now starting to do them for the first time. I feel a lot of them are going to use this as a catalyst to get rid of undesirable patients and difficult to manage cases.

If you show up with a false positive or false negative or something you shouldnt have in there you are out the door! I think that is crappy practice! You cant just throw someone out like that! they need to be taking this time to do some counseling and get a referral to an addictions specialist if appropriate but it looks like a lot of people on here are just getting tossed out! It is shameful! Many Drs do have their limits as to what they will prescribe and some states have laws now that limit the amount the Drs can prescribe whether the Dr wants to or not. I know Washington State has limits and I think Florida and Virginia do too. Are you in any of these states? this might be the reason he is not giving more. If you dont mind my asking, what all meds are you on and what state you live in? If you tell me, I can tell you whether or not your Dr is being reasonable and give you better advice as to whether you should see someone else.

There are a lot of components to REMS. Mainly it is educating Drs better in how to manage pain, how to look for diversion (hence all the UDS happening at the first of the year by docs who never did them before) just google REMS and see if you can find it. They have quite a bit about it on many of the pain advocate sites like National Pain Foundation, American Pain Association and American Pain Society. One of my favorite sites is pain-topics.org-some really good info on there-you can find a lot about REMS on there. REMS stands for Risk Evaluation and Mitigation Strategies.

then there is also Obamas plan to reduce drug abuse in the US and he is asking for more screening and earlier intervention for those showing aberrant behaviors and pushing for ALL states to have a prescription monitoring program which cracks down on Dr shoppers because ALL your controlled substances you have filled, no matter if they are paid in cash or go through insurance, go into a central database and if they see you are getting opioids and other controlled drugs from more than one source they can notify your Drs and even law enforcement if necessary. Some of it I think is a good thing but it can also open a lot of doors for government telling you how to run your life. It is important as you go into election time that you support candidates who support pain management for those who need it. I truly would like to see abusers get help and people who are diverting drugs to the streets and getting kids addicted should be punished but it shouldnt be at the expense of pain sufferers. I'm very much for pain advocacy and amking sure that people dont suffer! I encourage all of you who are also in chronic pain to become proactive too! Join the American Pain Society if you can-they do wonderful things to advocate for those in chronic pain. They deserve our support. Also check out some of the articles on pain-topics.org there is a great series of articles on there about the war on drugs in the US-VERY ENLIGHTENING to say the least!! There is such a wealth of info on that site. You will really like it. It is probably the second most used site behind drugs.com that I use every day!

Are you going to one hospital? Many hospitals have a free referal service. You can call them and get info on different types of doctors, such as a neuro-surgeon or regular back surgeon. They can give you their CV info, too. What type of treatments have they tried to reduce the pain. That can help, too. What pain meds are you on? Good luck!

My doctor recomended I try over the counter Magnesium, 400 mg. 1 at night and if that doesn't work, add 1 in the morning. You don't need a prescription for that. Also, low levels of methodone might help...

Thanks snoopytann... I had back surgery in early December... 2 vertabrae were re-built - my doctor told me that was the reason that my hip and leg hurt... it was "referred" pain. 6 weeks after the surgery, when they reduced the pain meds I was on, the pain in my hip/leg came back with a vengence, so, I feel that the surgery didn't do what it was supposed to do, and I still have horrible back pain. He's got me on 4 500/5 vicodin a day... I need to take Aleve and tramadol throughout the day to keep the pain down enough so that I can walk. They haven't tried any other treatments on me..except I do go to physical therapy 2X a week, which really helps with the pain, for a few hours. I go to sleep at night with a heat pad and wake up early in the morning to take some meds and lie on the heat pad for an hour so I can get up and face the day. In the past, I used norco, but got up to way too many, 10-15/day, which was not good, yet, I wasn't in this pain.

They've done an MRI and a nerve study and can't figure out why I'd be in pain... well, I don't know either... all I know is that before the surgery, I could walk much better than I can walk now. I do have a referral to another pain mgmt doc thru my primary care doctor and will use it if I don't get some satisfaction from an appt. with him on 3/6. And, that's my story...

This is why I'm terified to have surgery myself! I've heard WAYYYY too many stories like yours. For every one person who has a good surgical outcome there are 10 or more who didnt. They tell me it is 70/30 chance for success but it seems way different than that when I talk to people more like 30/70! Then when they do surgery they expect you to be all better and just cant figure out why you are not and they want to cut out your meds so you are in pain forever before they decide you had a failed surgery, no thanks! I feel for you truly!

Jbird-They told me my lower back pain is referred but related to the nerves. The body can 're-route' the nerve pain to a different area. Thus, the brain percieves the pain in a different location and the tests won't find that. Sucks, but according to my doctor, true.

AN

Anonymous8 Mar 2012

If it was your low back, it's not referred it's nerve damage to the sciatic nerve root. I have suffered with it for 44 damn years! It doesn't get any better either, sometimes worse. I use my pain meds, a muscle relaxer & heating pad too... Mary

These days it seems that Drs. are cautious and seem to suspect users of narcotics for pain of being "fraudulent" when requesting additional medication. I would also say that it varies from state to state. I viewed a program on Current TV called "The Oxycoten Express". There was one county in FL that was responsible for 90% of the Oxycotin scripts written in the US. In these "Pill Mills" all you needed was cash. People were comming from various states and getting Oxycotin perscribed for a price not level of pain. This is an extreme case but the point is with the right doctor you should be able to find relief for your pain. I have had 3 different doctors in the past all who were sympathetic to my needs. Sometimes all it takes is changeing up narcotics you might see if your current doctor would be willing to do that. It might be easier than finding another source of pain medication. If you have had your present Dr. for some time inquire about this.

Just to share again, my experience, I was put on methadone after a few years of using vicodan for my pain problems, at 5mg.I ended upp on 150mg a day of methdaone, & was a totol zombie. Lost 10 years of my life, & put not only my own , but others at risk going to these appt.s while driving & falling asleep. I begged my Pain doc tochange me back to vicodan & it can be taken as needed, not on a regular basis. That way I could drive myself to appt.s etc..& take a pill when I got home. She did agree, since my once thought liver problem turnedout to a common bile duct problem, & was fixed with ERCP surgery (twice) I had to wean down & the chrontic pain was excruitating. It took me almost a year to do this & it was very hard on me. When I went back to thepain doc she said she couldn't write 4 to 6 hour pain meds anymorre because the FDA wouldn't let her. She could worte for an extended type like Embeda which she promplty gave.

I took one at 7 PM that night & woke up (thankfully) with my eyes swelled shut, & puffed up all over. I went straight back to the clinic & told them I had an allergic reaction to their Embeda, "well then, that too bad guess you'll have to take the methadone then or nothing". Prissay a$$ nurse(no offense Dzoo) felt like she ran the place. I called again the next day as I was about out of the methadone & asked if there was anything else they could give me, "well, MS Contin (which is also morphine)or methadone is all we can prescribe". No short acting scripts. I live in Ill. on the Mississippi in the Quad Cities so Davenport Ia, is just across the bride & we are one big community. I went to my PCP in Ill., & cried & begged for him to take over my pain scripts again. I had never heard of pain clinics before the methadone route. Anyway he couldn't write them either anymore be cause they blood tested al patients on pain meds & found 50% did not have ANY in their systems! He did however, get on his phone & called & talked to every pain mangt place around here til he found one that had no problem writing me a pain script for 4 to 6 hour pain meds. I have been very happy with my new doc (whom in a year I have seen one time) his nurse practitioner writes scripts & evaluate you along with a physchologist. I just saw her one time too. So every three months I go to get see my nurse practioner, & they send it to me in the mail monthly. I am now on oxycodone 15mg, & was on Lyrica which really helped my pain, but had too many side effects right now to continue to take. Oh, & the new doc told me they COULD have written me a new script for vicodan, just didn't want to because then they had to start urine testing all patients. Now what kind of sense does that make? My hubby still goes to that clinic & gets 180 10mg methadones tabs a month! They are one of the biggest selling street drugs around! My suggestion is to talk to your PCP about the problem if you have a good relationship, & have them refer you to a Pain Mangement clincic that actually manages pain, not worried about getting into trouble. I had to give a urine test to my PCP for xanax & was asked by the new pain management the first day (1 hour later) for another. I still had my xanax in my little paws, so told them had just gave a urine sample at my rreferring docs & they just had them phonw in the results, & took over my sanax script for me too, so I wouldn't have to do this every month in Illinois. I wish you the best... MaryP.S., when you see a new Pain management doctor that automatically voids your contract with the old doctor.

Wow Mary632009, you've been through so much. Thanks for sharing your story with me... it really helped me. Please wish me luck with the doctor's appt. on March 6th... he gets me all tongue-tied and nervous..I want them to figure out what is wrong with me, and I want them to give me enough meds so I'm not in pain and under stress from the pain...

AN

Anonymous6 Mar 2012

I wish you all the luck in the world! Don't go in begging for this or that or they will look at you like a drug user & seeker, ask them what they reccomend. Just a hint... Mary

AN

Anonymous6 Mar 2012

I begged & then tell you not to? Well, my PCP has known me for years & years & knows of all my conditions, so felt like I could cry & beg to him & is a friend... Mary

Good news... I had a really great visit with my pm physician... it really seemed like he was listening this time. I'm having another epidural, he also put me on Neurontin and switched my vicodin to a higher strength Norco, which has worked well for me in the past. I'm finally feeling mentally better and not as depressed, due to this latest visit. I'm going to start taking the Neurontin tomorrow. Any other words of advice? Thanks again for all your suggestions.

AN

Anonymous8 Mar 2012

That is indeed good news. I wish you the most pain relief you can get... Mary